POS0724 RISK FACTORS FOR CORONARY ARTERY DISEASE IN CHINESE PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A MULTI-CENTER, RETROSPECTIVE, COHORT STUDY
Authors: W. Ci, J. Zhao, Y. Wang, L. Pan, M. Li
Journal: Annals of the Rheumatic Diseases (2022)

Background Coronary artery disease (CAD) not only has an increased prevalence but also is a major cause of premature mortality in systemic lupus erythematosus (SLE) [1, 2] . However, information is limited regarding the risk factors for CAD in Chinese patients with SLE. Objectives To assess the risk factors for CAD in Chinese patients with SLE. Methods This multi-center, retrospective, cohort study included 3778 consecutive SLE patients, with CAD (CAD group) or without a medical history of CAD (control group). CAD was defined as a coronary stenosis ≥50% in any major epicardial coronary vessel detected by coronary angiography or a history of myocardial infarction confirmed by medical records. General parameters, clinical features, laboratory tests and medical therapies were compared between groups, and the risk factors for CAD in SLE were analyzed by logistic regression analysis. Results The age at baseline was older, male ratio was higher and body mass index was greater in CAD group (all P &lt;0.001). Traditional CAD risk factors including diabetes mellitus, hypertension, dyslipidemia, family history of CAD and smoking were more common in CAD group (all P &lt;0.001) (Figure 1). SLE Disease Activity Index 2000 was greater ( P =0.012), hyperuricemia and elevated C-reactive protein (CRP) were more prevalent (both P &lt;0.001), and an increased corticosteroids’ usage ( P =0.018) was detected in CAD group (Table 1). Binary logistic regression analysis showed hyperuricemia (odds ratio: 3.082, 95% confidence interval: 1.283-7.403; P =0.012) and CRP (odds ratio: 7.248, 95% confidence interval: 2.931-17.925; P &lt;0.001) were independent risk factors for CAD in SLE patients. Table 1. Comparison of clinical features in SLE patients between CAD group and control group. Parameters Control group (n=3732) CAD group (n=46) P Age at baseline [years, median (P25, P75)] 35.00 (29.00, 45.00) 59.50 (50.25, 67.75) &lt;0.001 Male, n (%) 296 (7.94) 11 (23.91) &lt;0.001 Disease duration [years, median (P25, P75)] 8.00 (4.00, 12.00) 10.00 (4.00, 19.00) 0.173 Body mass index [kg/m 2 , median (P25, P75)] 21.77 (19.63, 24.16) 23.50 (22.09, 25.36) &lt;0.001 Renal disorder, n (%) 1737 (46.57) 9 (19.57) &lt;0.001 Neurologic disorder, n (%) 595 (15.95) 3 (6.52) 0.082 Thrombocytopenia, n (%) 859 (23.03) 8 (17.39) 0.366 SLEDAI-2K [median (P25, P75)] 3.00 (0.00, 8.00) 5.50 (1.50, 14.00) 0.012 Elevated creatinine, n (%) 295 (7.91) 10 (21.74) 0.002 Hyperuricemia, n (%) 209 (5.60) 16 (34.78) &lt;0.001 Elevated ESR, n (%) 951 (25.5) 22 (47.83) 0.001 Elevated CRP, n (%) 210 (5.63) 15 (32.61) &lt;0.001 Positive aPL, n (%) 734 (19.68) 11 (23.91) 0.474 Corticosteroids, n (%) 2752 (73.78) 41 (89.13) 0.018 Immunosuppressants, n (%) 2950(79.09) 37 (80.43) 0.823 Abbreviations: aPL, antiphospholipid antibody; CAD, coronary artery disease; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; SLE, systemic lupus erythematosus; SLEDAI-2K, SLE Disease Activity Index 2000. P &lt;0.05 are shown as italics and bold. Figure 1. Comparison of traditional risk factors in SLE patients between CAD group and control group. Abbreviations: CAD, coronary artery disease; SLE, systemic lupus erythematosus. All P &lt;0.001. Conclusion Hyperuricemia and CRP are independent risk factors for CAD in SLE patients. This study highlights the association between hyperuricemia, CRP and CAD burden in SLE, and might provide a modifiable perspective on improving SLE outcomes. References [1]Gonzalez LA, Alarcon GS. The evolving concept of SLE comorbidities [J]. Expert Rev Clin Immunol, 2017, 13(8): 753-768. [2]Kostopoulou M, Nikolopoulos D, Parodis I, et al. Cardiovascular Disease in Systemic Lupus Erythematosus: Recent Data on Epidemiology, Risk Factors and Prevention [J]. Curr Vasc Pharmacol, 2020, 18(6): 549-565. Disclosure of Interests None declared